The Relationship Between Halitosis and Anxiety in Medical Students Faculty of Medicine at Universitas Katolik Atma Jaya

Authors

  • Cleo Michaela Latumahina Department of Dental Medicine, School of Medicine and Health Sciences, Universitas Katolik Atma Jaya, Indonesia
  • Indriani Oktaria Department of Dental Medicine, School of Medicine and Health Sciences, Universitas Katolik Atma Jaya, Indonesia
  • Lonah Department of Dental Medicine, School of Medicine and Health Sciences, Universitas Katolik Atma Jaya, Indonesia

DOI:

https://doi.org/10.46862/interdental.v21i2.12197

Keywords:

Anxiety, halitosis, oral malodor, questionnaire

Abstract

Introduction: Halitosis is a common occurrence among people. Halitosis can be classified as genuine halitosis, where the sufferer genuinely has bad breath that can be smelled by people around them, or as delusional halitosis, where the sufferer believes that they have bad breath but it cannot be smelled by people around them. Halitosis can become a significant problem, especially when the sufferer is socializing with others, due to the anxiety that their bad breath might disturb their conversation partners. This condition can lead to poor communication skills and actions of isolation or withdrawal from others.

Material & methods: This study seeks to explore the perceptions and knowledge of medical students at Universitas Katolik Atma Jaya about halitosis, as well as its impact on their anxiety levels. Utilizing a cross-sectional design, the research involved 150 students from the Faculty of Medicine and Health Sciences, class of 2020–2022. Halitosis, as the independent variable, was assessed using the Halitosis Consequences Inventory (ICH), while anxiety, the dependent variable, was measured through the Depression Anxiety Stress Scale (DASS-42). Data analysis was conducted using the Spearman Rank Correlation Coefficient test.

Results: Results of the research are 34.7% of Faculty of Medicine at Universitas Katolik Atma Jaya’s students from the class 2020-2022 experience halitosis, while 65.3% experience anxiety. 76.9% of students with halitosis also experience anxiety. The results of the Spearman Rank Correlation Coefficient test indicate a weak positive correlation (rs = 0.321) that is statistically significant (p = 0.000) between halitosis and anxiety. In other words, there is a tendency that an increase in halitosis will affect the increase in anxiety levels.

Conclusion Relation between halitosis and anxiety is a synergy (positive correlation).   Halitosis has a moderate positive influence on anxiety among the students of the Faculty of Medicine at Universitas Katolik Atma Jaya, class of 2020. This indicates that students experiencing halitosis are concerned about their bad breath, which affects their social communication. Therefore, the approach to treating halitosis should include both physical treatment (halitosis) and mental health care.

Downloads

Download data is not yet available.

References

1. Tungare S, Zafar N, Paranjpe AG. Halitosis. Treasure Island: StatsPearl; 2022.

2. Silva MF, Leite FRM, Ferreira LB, Pola NM, Scannapieco FA, Demarco FF, Nascimento GG. Estimated prevalence of halitosis: a systematic review and meta-regression analysis. Clin Oral Investig 2018;22(1):47–55. Doi: 10.1007/s00784-017-2164-5.

3. Vali A, Roohafza H, Hassanzadeh Keshteli A, Afghari P, Javad Shirani M, Afshar H, Savabi O, Adibi P. Relationship between subjective halitosis and psychological factors. Int Dent J 2015; 65(3): 120–6. Doi: 10.1111/idj.12153.

4. Kapoor U, Sharma G, Juneja M, Nagpal A. Halitosis: Current concepts on etiology, diagnosis, and management. Eur J Dent 2016; 10(2): 292. Doi: 10.4103/1305-7456.178294

5. Teshome A, Derese K, Andualem G. The prevalence and determinant factors of oral halitosis in northwest Ethiopia: A cross-sectional study. Clin Cosmet Investig Dent 2021;13:173. Doi: 10.2147/CCIDE.S308022.

6. Mark AM. Controlling bad breath. Journal of the American Dental Association 2021; 152(7): 582. Doi: 10.1016/j.adaj.2021.03.009

7. Wu J, Cannon RD, Ji P, Farella M, Mei L. Halitosis: prevalence, risk factors, sources, measurement and treatment – a review of the literature. Aust Dent J 2020; 65(1): 4–11. Doi: 10.1111/adj.12725.

8. Outhouse TL, Fedorowicz Z, Keenan J V, Al-Alawi R. A Cochrane systematic review finds tongue scrapers have short-term efficacy in controlling halitosis. Gen Dent 2006; 54(5): 352–9; 360, 367–8; quiz 360.

9. da Conceicao MD, Giudice FS, Carvalho L de F. The halitosis consequences inventory: psychometric properties and relationship with social anxiety disorder. BDJ Open 2018; 4(1): 18002. Doi: 10.1038/bdjopen.2018.2

10. Makara-Studzińska M, Tyburski E, Załuski M, Adamczyk K, Mesterhazy J, Mesterhazy A. Confirmatory factor analysis of three versions of the depression anxiety stress scale (DASS-42, DASS-21, and DASS-12) in polish adults. Front Psychiatry 2022; 12: 770532. Doi: 0.3389/fpsyt.2021.770532

11. Arindra DIah A, Sri Kusrohmaniah. Uji validitas dan reliabilitas skala depression, anxiety, and stress scale-42 (Dass-42) versi bahasa indonesia pada sampel emerging adulthood. 2022; Available from: http://etd.repository.ugm.ac.id/penelitian/detail/215931

12. Rusdi Maslim. Buku Saku Diagnosis Gangguan Jiwa: Rujukan RIngkas dari PPDGJIII, DSM-5, ICD-11. 2 ed. Jakarta: PT Nuh Jaya; 2013.

13. Mayo Clinic. Anxiety disorders - Symptoms and causes - Mayo Clinic [Internet]. 2018 [dikutip 2023 Mar 17];Available from: https://www.mayoclinic.org/diseasesconditions/anxiety/symptoms-causes/syc-20350961

14. Psychology Foundation of Australia. Depression Anxiety Stress Scales - DASS [Internet]. 2022 [dikutip 2023 Mar 27];Available from: http://www2.psy.unsw.edu.au/dass/

15. Tsang S, Royse C, Terkawi A. Guidelines for developing, translating, and validating a questionnaire in perioperative and pain medicine. Saudi Journal of Anaesthesia 2017; 11(5): 80. Doi: https://doi.org/10.4103/sja.SJA_203_17

16. Briceag R, Caraiane A, Raftu G, Horhat RM, Bogdan I, Fericean RM, et al. Emotional and social impact of halitosis on adolescents and young adults: A systematic review. Medicina 2023;59(3):564. Doi: 10.3390/medicina59030564

17. Mayo Clinic. Anxiety disorders - Symptoms and causes - Mayo Clinic [Internet]. 2018 [dikutip 2023 Mar 17];Available from: https://www.mayoclinic.org/diseasesconditions/anxiety/symptoms-causes/syc-20350961

18. Makara-Studzińska M, Tyburski E, Załuski M, Adamczyk K, Mesterhazy J, Mesterhazy A. Confirmatory factor analysis of three versions of the depression anxiety stress scale (DASS-42, DASS-21, and DASS-12) in polish adults. Front Psychiatry 2022; 12: 770532. Doi: 0.3389/fpsyt.2021.770532

19. Arindra DIah A, Sri Kusrohmaniah. Uji validitas dan reliabilitas skala depression, anxiety, and stress scale-42 (Dass-42) versi bahasa Indonesia pada sampel emerging adulthood. 2022; Available from: http://etd.repository.ugm.ac.id/penelitian/detail/215931

20. Psychology Foundation of Australia. Depression Anxiety Stress Scales - DASS [Internet]. 2022 [dikutip 2023 Mar 27]; Available from: http://www2.psy.unsw.edu.au/dass/

21. Tsang S, Royse C, Terkawi A. Guidelines for developing, translating, and validating a questionnaire in perioperative and pain medicine. Saudi Journal of Anaesthesia 2017; 11(5): 80. Doi: https://doi.org/10.4103/sja.SJA_203_17/medicina59030564

Downloads

Published

2025-08-05

How to Cite

1.
Latumahina CM, Oktaria I, Lonah. The Relationship Between Halitosis and Anxiety in Medical Students Faculty of Medicine at Universitas Katolik Atma Jaya. interdental [Internet]. 2025 Aug. 5 [cited 2025 Aug. 8];21(2):212-20. Available from: https://e-journal.unmas.ac.id/index.php/interdental/article/view/12197